Traveling Science Program Science Inquiry Fund Application - Da Vinci Science Center - Da Vinci Science Center

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H/Traveling Science Program Science Inquiry Fund Application

Traveling Science Program Science Inquiry Fund Application

Outreach Science Inquiry Fund Form

School Information
School/Group Name*
School District*

Write N/A if not applicable.
School Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Contact Name*
First Last
Email*
Phone*
Have you received STEAM Scholarship Funds in the past?*
- Yes
- No
- Unsure
Please state the year, amount, and use of the Funds*
Student Grade Level(s)*
Science topics taught:*
Percentage of students eligible for free/reduced lunch in your school*
Percentage of students eligible for PA Child Care Works Subsidy*
(for childcare facilities only, write N/A if not applicable)
Essay Questions
How will your students benefit from the program (250 words or less)?*
What are your school or organization's goals and how will the program you are requesting support the outcomes you work towards (250 words or less)?*
Describe what is done in your classroom to inspire the exploration, understanding, and appreciation of science, technology, engineering, art, and math (STEAM) in your students.*
How can Da Vinci Science Center support your school or organization's STEAM curriculum and planning efforts?*
Outreach Program Request
Type of request (select all that apply)*
- Outreach Classroom Program
- Outreach Science Show
- Outreach Science Celebration
- Outreach Community Event
Outreach Classroom Program
Select which Classroom Program(s) you are interested in.*
- Wee Engineers (PreK)
- Eco Explorers (K-2)
- The Secret Life of Seeds (K-2)
- Bubble Bonanza: Engineering Bubble Wands (K-2)
- Paws of Attraction (3-5)
- Made in America (3-5)
- Music to My Ears: An Acoustical Engineering Challenge (3-5)
- Medical Mystery (6-12)
- Picture an Eclipse (6-12)
- Apex Innovators (6-12)
- Kinetic Sculptures (6-12)
Number of Students*
Preferred date(s) and time(s) for your Outreach Classroom Program*
Outreach Science Show Request
Number of Students*
Select all Outreach Science Shows you are interested in*
- Mixing Matter (K-8)
- Shocking Discoveries (4-12) (fall/winter only)
- Use the Force (4-12)
Preferred date(s) and time(s) for your Outreach Science Show*
Outreach Science Celebrations Request
Select all Science Celebrations you are interested in*
- STEAM Fest
- Space Fest
Preferred date(s) and time(s) for your Outreach Science Celebration*
Outreach Community Event Request
Preferred date(s) and time(s) for your Outreach Community Event*
Select the Table-Top Activities you're interested in*
- Bubble Wands (PreK-Grade 2)
- Bee Bot Coding (PreK)
- Color Creations (Grades K-2)
- Plant Terrariums (Grades K-2)
- KEVA (Grades K-5)
- Wind Tubes (Grades K-5)
- Composting (Grades 3-5)
- Musical Proportions (Grades 3-5)
- Circuits (Grades 3-12)
- Syndaver (Grades 6-12)
- Virus Modeling (Grades 6-12)
Tell us about your event. Do you have any special activities in mind?*
Additional Information
Comments/Questions
By checking this box, you acknowledge that all of the above information is accurate and that the funds will be used as indicated here.*
- Acknowledged
Date*
MM slash DD slash YYYY

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United Way of the Greater Lehigh Valley
Association of Science and Technology Centers
National Science Foundation

This project was financed by a grant from

Pennsylvania Department of Community & Economic Development
Institute of Museum and Library Services
Pennsylvania Historical and Museum Commission

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